1. Field of the Invention
The present invention relates to biologically compatible, non-fouling coatings for implantable medical devices such as stents.
2. Description of the State of the Art
Percutaneous transluminal coronary angioplasty (PTCA) is a procedure for treating heart disease. A catheter assembly having a balloon portion is introduced percutaneously into the cardiovascular system of a patient via the brachial or femoral artery. The catheter assembly is advanced through the coronary vasculature until the balloon portion is positioned across the occlusive lesion. Once in position across the lesion, the balloon is inflated to a predetermined size to radially compress against the atherosclerotic plaque of the lesion to remodel the lumen wall. The balloon is then deflated to a smaller profile to allow the catheter to be withdrawn from the patient's vasculature.
A problem associated with the above procedure includes formation of intimal flaps or torn arterial linings which can collapse and occlude the conduit after the balloon is deflated. Moreover, thrombosis and restenosis of the artery may develop over several months after the procedure, which may require another angioplasty procedure or a surgical by-pass operation. To reduce the partial or total occlusion of the artery by the collapse of arterial lining and to reduce the chance of the development of thrombosis and restenosis, a stent is implanted in the lumen to maintain the vascular patency. Examples in patent literature disclosing stents which have been applied in PTCA procedures include stents illustrated in U.S. Pat. No. 4,733,665 issued to Palmaz, U.S. Pat. No. 4,800,882 issued to Gianturco, and U.S. Pat. No. 4,886,062 issued to Wiktor. Biological therapy can be achieved by medicating the stents. Medicated stents provide for the local administration of a therapeutic substance at the diseased site. In order to provide an efficacious concentration to the treated site, systemic administration of such medication often produces adverse or toxic side effects for the patient. Local delivery is a preferred method of treatment in that smaller total levels of medication are administered in comparison to systemic dosages, but are concentrated at a specific site. Local delivery thus produces fewer side effects and achieves more favorable results. One proposed method for medicating stents involves the use of a polymeric carrier coated onto the surface of a stent. A solution which includes a solvent, a polymer dissolved in the solvent, and a therapeutic substance dispersed in the blend is applied to the stent. The solvent is allowed to evaporate, leaving on the stent surface a coating of the polymer and the therapeutic substance impregnated in the polymer. Once the stent has been implanted at the treatment site, the therapeutic substance has a sustained release profile from the polymer.
As a result of the implantation of bare metal stents, a low incidence of stent thrombosis can occur, even when the anticoagulation therapy is administered before, during, and after stent implantation. Although thrombosis is only a low incidence problem for the average patient, patients having problems with blood hyper-coagulation, e.g., patients having small vessels, or those suffering from diabetes, are expected to benefit from less thrombogenic stents. Therefore, improved means of tethering anti-thrombogenic and non-thrombogenic moieties to stents is desirable.
In addition, once a bare metal stent is implanted, a thick, denatured layer of protein typically tends to accumulate on a stent surface as a result of the body's reaction to a foreign material. Such accumulation, or “fouling” of the stent surface, is undesirable from the point of view of the stent's long-term tissue compatibility. Surfaces treatments, which can reduce this chronic, foreign body reaction, to make the stent surface non-fouling or at least less fouling are, thus, beneficial. Therefore, improved means of tethering anti-fouling and non-fouling moieties to stents is also desirable.
Although local administration of therapeutic agents via stents has shown favorable results in reducing restenosis, improvements can be made to the coatings. One improvement is to have drug eluting stent coatings, and biologically compatible stent coatings that are firmly anchored to the stent surface. The embodiments of the present invention provide, among other advantages and improvements, a means of tethering biologically compatible or non-fouling polymers to bare metal stents. In addition, incorporating the compounds described in the present invention into a stent primer allows to have improved adhesion of the stent coatings to the stents.